What type of loan are you looking for?

30 year fixed rate	20 year fixed rate	10 year fixed rate
10 year ARM	5 year ARM	3 year ARM	1 year ARM
30 year FHA-fixed	15 year FHA- fixed	30 year FHA ARM
30 year VA
Other

When completing the following information, please include the income and debts information of all parties who will be applying for financing. Note that alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered for repaying the loan.

Total Income Primary Applicant		$
Current employers name:
Years with current employer:
Income is:	Annual Monthly Weekly Hourly
If income is hourly, please enter hours per week.
Monthly Income:
Total Income Co-Applicant		$
Current employers name:
Years with current employer:
Income is:	Annual Monthly Weekly Hourly
If income is hourly, please enter hours per week.
Monthly Income:

Total Monthly Debts       All Applicants	Balance	Monthly Payment
Charge Accounts - total
Auto Loans - total
Home Improvement Loans - total
Current Housing Payment - total
Other Monthly Debts - total
Monthly Debt:
Funds Available for Closing Costs & Down Payment
Checking Account(s) - total
Savings Account(s) - total
Other (please describe):
Other (please describe):
Total Funds Available:

Desired Loan Amount
Desired Purchase Price

Any Comments?

I / We authorize Glenwood Financial I, Inc.  to obtain a credit history and use the above
information for the purpose of determining a pre-qualification for a mortgage loan. Yes No    

Social Security #
Co-Applicant Social Security #